Good afternoon. There's a medical revolution happening all around us, and it's one that's going to help us conquer some of society's most dreaded conditions, including cancer. The revolution is called angiogenesis, and it's based on the process that our bodies use to grow blood vessels.
Dobar dan. Svuda oko nas se dešava jedna medicinska revolucija, a to je ona koja će nam pomoći da pobedimo neka od stanja kojih se najviše bojimo, uključujući rak. Ta revolucija se naziva angiogeneza i zasnovana je na procesu koji naša tela koriste da proizvode krvne sudove.
So why should we care about blood vessels? Well, the human body is literally packed with them -- 60,000 miles worth in a typical adult. End to end, that would form a line that would circle the earth twice. The smallest blood vessels are called capillaries. We've got 19 billion of them in our bodies. And these are the vessels of life, and as I'll show you, they can also be the vessels of death. Now, the remarkable thing about blood vessels is that they have this ability to adapt to whatever environment they're growing in. For example, in the liver, they form channels to detoxify the blood; in the lungs, they line air sacs for gas exchange. In muscle, they corkscrew, so that muscles can contract without cutting off circulation. And in nerves, they course along like power lines, keeping those nerves alive.
Dakle, zašto bismo brinuli o krvnim sudovima? Pa, ljudsko telo je bukvalno njima pretrpano, u tipičnom odraslom telu ih ima oko 96000km. Od jednog do drugog kraja, to bi formiralo liniju koja bi obišla oko Zemlje dva puta. Najmanji krvni sudovi nazivaju se kapilari. U telu ih imamo 19 milijardi. Ovo su krvni sudovi života i kao što ću vam pokazati, mogu takođe biti i krvni sudovi smrti. Izvanredna stvar u vezi s krvnim sudovima jeste njihova sposobnost da se prilagode bilo kakvom okruženju u kom se razvijaju. Na primer, u jetri formiraju kanale da prečiste krv. U plućima, okružuju kesice sa vazduhom za razmehu kiseonika. U mišićima krivudaju, tako da mišići mogu da se stežu, a da ne prekinu cirkulaciju. A u nervima, oni se protežu kao strujni kablovi, održavajući te nerve živim.
We get most of these blood vessels when we're actually still in the womb. And what that means is that as adults, blood vessels don't normally grow. Except in a few special circumstances. In women, blood vessels grow every month, to build the lining of the uterus. During pregnancy, they form the placenta, which connects mom and baby. And after injury, blood vessels actually have to grow under the scab in order to heal a wound. And this is actually what it looks like, hundreds of blood vessels, all growing toward the center of the wound.
I većinu ovih krvnih sudova dobijemo dok smo još u materici. A to znači da, kod odraslih, ne nastaju novi krvni sudovi, osim u nekoliko posebnih slučajeva. Kod žena, krvni sudovi nastaju svakog meseca da ograde matericu. Tokom trudnoće, oni formiraju palcentu, koja povezuje majku i bebu. A posle povrede, krvni sudovi zapravo moraju da nastaju ispod kraste kako bi zalečili ranu. To ovako izgleda. Stotine krvnih sudova koji se formiraju ka centru rane.
So the body has the ability to regulate the amount of blood vessels that are present at any given time. It does this through an elaborate and elegant system of checks and balances, stimulators and inhibitors of angiogenesis, such that, when we need a brief burst of blood vessels, the body can do this by releasing stimulators, proteins called angiogenic factors, that act as natural fertilizer, and stimulate new blood vessels to sprout. When those excess vessels are no longer needed, the body prunes them back to baseline, using naturally-occurring inhibitors of angiogenesis. There are other situations where we start beneath the baseline, and we need to grow more blood vessels, just to get back to normal levels -- for example, after an injury -- and the body can do that too, but only to that normal level, that set point.
Znači telo je sposobno da kontroliše količinu krvnih sudova koji postoje u bilo kom trenutku. A to čini jednim složenim i elegantnim sistemom podele moći, stimulatorima i inhibitorima angiogeneze, tako da, kada su nam brzo potrebni krvni sudovi, telo to može da učini otpuštajući stimulatore, proteine koji se zovu angiogenski faktori koji se ponašaju kao prirodno đubrivo i stimulišu cvetanje novih krvnih sudova. I kada ti dodatni sudovi nisu više potrebni, telo ih smanji na osnovni nivo, koristeći prirodne inhibitore angiogeneze. Postoje druge situacije kada polazimo ispod osnovnog nivoa, kada nam je potrebno da proizvedemo više krvnih sudova da bismo se vratili na normalni nivo. Na primer, posle povrede. Telo može i to da uradi, ali samo do normalnog nivoa, te određene tačke.
But what we now know, is that for a number of diseases, there are defects in the system, where the body can't prune back extra blood vessels, or can't grow enough new ones in the right place at the right time. And in these situations, angiogenesis is out of balance. And when angiogenesis is out of balance, a myriad of diseases result. For example, insufficient angiogenesis -- not enough blood vessels -- leads to wounds that don't heal, heart attacks, legs without circulation, death from stroke, nerve damage. And on the other end, excessive angiogenesis -- too many blood vessels -- drives disease, and we see this in cancer, blindness, arthritis, obesity, Alzheimer's disease. In total, there are more than 70 major diseases affecting more than a billion people worldwide, that all look on the surface to be different from one another, but all actually share abnormal angiogenesis as their common denominator. And this realization is allowing us to re-conceptualize the way that we actually approach these diseases, by controlling angiogenesis.
Ali sada znamo da, kod nekih bolesti, postoje greške u sistemu, kada telo ne može da smanji višak krvnih sudova ili ne može da proizvede nove u pravo vreme na pravom mestu. U tim situacijama, angiogeneza nije u ravnoteži. A kada je angiogeneza u neravnoteži, može se javiti bezbroj bolesti. Na primer, nedovoljna angiogeneza, nedovoljno krvnih sudova, vodi do rana koje ne zarastaju, do srčanih udara, nogu bez cirkulacije, smrti od moždanog udara, oštećenja nerava. S druge strane, preterana angiogeneza, previše krvnih sudova, podstiče bolesti. To vidimo kod raka, slepila, artritisa, gojaznosti, Alchajmerove bolesti. Sve ukupno, postoji preko 70 ozbiljnih oboljenja koja muče više od milijardu ljudi širom sveta, koja na površini izgledaju kao da se razlikuju ali zapravo im je abnormalna angiogeneza zajednički imenitelj. I ovo otkriće nam omogućava da preispitamo način na koji prilazimo ovim bolestima,
Now, I'm going to focus on cancer, because angiogenesis is a hallmark of cancer -- every type of cancer. So here we go. This is a tumor: dark, gray, ominous mass growing inside a brain. And under the microscope, you can see hundreds of these brown-stained blood vessels, capillaries that are feeding cancer cells, bringing oxygen and nutrients. But cancers don't start out like this, and in fact, cancers don't start out with a blood supply. They start out as small, microscopic nests of cells, that can only grow to one half a cubic millimeter in size. That's the tip of a ballpoint pen. Then they can't get any larger because they don't have a blood supply, so they don't have enough oxygen or nutrients.
tako što kontrolišemo angiogenezu. Sad ću se koncentrisati na rak, jer angiogeneza je obeležje raka, svakog tipa raka. Dakle, evo. Ovo je tumor, tamna, siva, zlokobna masa koja raste u jednom mozgu. I pod mikroskopom možete videti stotine ovih braon krvnih sudova, kapilara koji hrane ćelije raka, donoseći kiseonik i hranljive materije. Ali rak ne počinje na ovaj način. Ustvari, rak ne počinje dotokom krvi. Počinje kao mala, mikroskopska mreža ćelija koja može da naraste do veličine od samo pola kubnog milimetra. To je vrh hemijske olovke. Onda ne može da naraste jer se ne snabdeva krvlju, pa nema dovoljno kiseonika i hranljivih materija.
In fact, we're probably forming these microscopic cancers all the time in our body. Autopsy studies from people who died in car accidents have shown that about 40 percent of women between the ages of 40 and 50 actually have microscopic cancers in their breasts. About 50 percent of men in their 50s and 60s have microscopic prostate cancers, and virtually 100 percent of us, by the time we reach our 70s, will have microscopic cancers growing in our thyroid. Yet, without a blood supply, most of these cancers will never become dangerous. Dr. Judah Folkman, who was my mentor and who was the pioneer of the angiogenesis field, once called this "cancer without disease."
Ustvari, verovatno svo vreme proizvodimo ove mikroskopske rakove u našim telima. Izveštaji sa autopsija ljudi koji su poginuli u saobraćajnim nesrećama pokazuju da oko 40 procenata žena između 40 i 50 godina starosti zapravo ima mikroskopske rakove u svojim grudima. Oko 50% muškaraca u pedesetim i šezdesetim godinama ima mikroskopske rakove prostate. I praktično 100% nas, do vremena kada dođe u sedamdesete, imaće mikroskopske rakove u tiroidnoj žlezdi. Ipak, bez snabdevanja krvlju, većina ovih tumora nikada neće postati opasna. Dr Juda Folkman, koji je bio moj mentor i koji je pionir na polju angiogeneze, jednom je ovo nazvao "rak bez bolesti".
So the body's ability to balance angiogenesis, when it's working properly, prevents blood vessels from feeding cancers. And this turns out to be one of our most important defense mechanisms against cancer. In fact, if you actually block angiogenesis and prevent blood vessels from ever reaching cancer cells, tumors simply can't grow up. But once angiogenesis occurs, cancers can grow exponentially. And this is actually how a cancer goes from being harmless, to being deadly. Cancer cells mutate, and they gain the ability to release lots of those angiogenic factors, natural fertilizer, that tip the balance in favor of blood vessels invading the cancer. And once those vessels invade the cancer, it can expand, it can invade local tissues, and the same vessels that are feeding tumors allow cancer cells to exit into the circulation as metastases. And unfortunately, this late stage of cancer is the one at which it's most likely to be diagnosed, when angiogenesis is already turned on, and cancer cells are growing like wild.
Znači sposobnost tela da balansira angiogenezu, kada funkcioniše ispravno, sprečava krvne sudove da hrane rak. Ispostavlja se da je ovo jedan od najvažnijih odbrambenih mehanizama protiv raka. Ustvari, ako blokirate angiogenezu i sprečite krvne sudove da stignu do ćelija raka, tumori jednostavno ne mogu da rastu. Ali kada nastane angiogeneza, tumori mogu eksponencijalno da rastu. Ovo je način na koji jedan rak od bezopasnog postaje smrtonosan. Ćelije raka mutiraju i stiču sposobnost da otpuštaju mnoge od ovih angiogenskih faktora, prirodnog đubriva, koji remete ravnotežu u korist krvnih sudova prodirući u rak. I kada ti sudovi prodru u rak, on se širi i može da prodre u okolna tkiva. I isti krvni sudovi koji hrane tumore omogućavaju ćelijama raka da uđu u cirkulaciju kao metastaze. I nažalost, u ovoj kasnoj fazi raka se on najčešće dijagnostikuje, kada je angiogeneza uključena i ćelije raka rastu kao lude.
So, if angiogenesis is a tipping point between a harmless cancer and a harmful one, then one major part of the angiogenesis revolution is a new approach to treating cancer by cutting off the blood supply. We call this antiangiogenic therapy, and it's completely different from chemotherapy, because it selectively aims at the blood vessels that are feeding the cancers. We can do this because tumor blood vessels are unlike normal, healthy vessels we see in other places of the body -- they're abnormal, they're very poorly constructed, and because of that, they're highly vulnerable to treatments that target them. In effect, when we give cancer patients antiangiogenic therapy -- here, an experimental drug for a glioma, which is a type of brain tumor -- you can see that there are dramatic changes that occur when the tumor is being starved. Here's a woman with a breast cancer, being treated with the antiangiogenic drug called Avastin, which is FDA approved. And you can see that the halo of blood flow disappears after treatment.
Dakle, ako je angiogeneza granica između bezopasnog i opasnog raka, onda je jedan veliki deo u revoluciji angiogeneze novi pristup tretmanu raka, prekidanjem snabdevanja krvlju. Ovo nazivamo terapijom antiangiogenezom i to je potpuno drugačije od hemoterapije jer selektivno cilja krvne sudove koji hrane rak. Ovo možemo da uradimo jer se krvni sudovi tumora razlikuju od normalnih, zdravih sudova koje vidimo na drugim mestima u telu. Oni su abnormalni; vrlo su slabo napravljeni i zbog toga su veoma osetljivi na tretmane koji ih ciljaju. Kao rezultat toga, kada obolelima od raka damo ovakvu terapiju - ovde, eksperimentalni lek za gliom, koji je vrsta tumora na mozgu - možete videti da se javljaju ozbiljne promene kada se tumor izgladnjuje. Ova žena ima rak dojke koji se tretira antiangiogenetskim lekom Avastinom, koji je odobrila administracija za hranu i lekove. I možete videti da je oreol toka krvi nestao posle tretmana.
Well, I've just shown you two very different types of cancer that both responded to antiangiogenic therapy. So a few years ago, I asked myself, "Can we take this one step further and treat other cancers, even in other species?" So here is a nine year-old boxer named Milo, who had a very aggressive tumor called a malignant neurofibroma growing on his shoulder. It invaded into his lungs. His veterinarian only gave him three months to live. So we created a cocktail of antiangiogenic drugs that could be mixed into his dog food, as well as an antiangiogenic cream, that could be applied on the surface of the tumor. And within a few weeks of treatment, we were able to slow down that cancer's growth, such that we were ultimately able to extend Milo’s survival to six times what the veterinarian had initially predicted, all with a very good quality of life. And we've subsequently treated more than 600 dogs. We have about a 60 percent response rate, and improved survival for these pets that were about to be euthanized.
Dakle, upravo sam vam pokazao dva veoma različita tipa raka koji su reagovali na antiangiogenetsku terapiju. Pre nekoliko godina sam se zapitao, "Možemo li ovo da odvedemo korak dalje, i lečimo druge tumore, čak i kod drugih vrsta?" Ovde je devetogodišnji bokser po imenu Majlo koji je imao veoma agresivni tumor po imenu maligni neurofibrom, koji je rastao na njegovom ramenu. Prešao mu je na pluća. Njegov veterinar mu je dao tri meseca života. Mi smo napravili koktel antiangiogenetskih lekova koji mogu da se pomešaju s njegovom hranom, kao i antiangiogenetsku kremu koja se može namazati na površinu tumora. I u okviru nekoliko nedelja tretmana uspeli smo da usporimo rast tog raka tako da smo na kraju mogli da produžimo Majlov život za šest puta u odnosu na veterinarevu prognozu, i to uz veoma dobar kvalitet života. Nakon toga smo lečili više od 600 pasa. Imamo oko 60% učinka i poboljšanog opstanka ovih ljubimaca koji bi bili uspavani.
So let me show you a couple of even more interesting examples. This is 20-year-old dolphin living in Florida, and she had these lesions in her mouth that, over the course of three years, developed into invasive squamous cell cancers. So we created an antiangiogenic paste. We had it painted on top of the cancer three times a week. And over the course of seven months, the cancers completely disappeared, and the biopsies came back as normal.
Pokazaću vam dva još interesantnija primera. Ovo je dvadesetogodišnji delfin koji živi na Floridi, i ona je imala ove lezije u ustima koje su se, tokom tri godine razvile u invazivne, slojevite ćelije raka. Napravili smo antiangiogenetsku pastu. Tri puta nedeljno smo je nanosili na rak. Tokom sedam meseci rak je u potpunosti nestao, a rezultati biopsije bili su normalni.
Here's a cancer growing on the lip of a Quarter Horse named Guinness. It's a very, very deadly type of cancer called an angiosarcoma. It had already spread to his lymph nodes, so we used an antiangiogenic skin cream for the lip, and the oral cocktail, so we could treat from the inside as well as the outside. And over the course of six months, he experienced a complete remission. And here he is six years later, Guinness, with his very happy owner.
Ovde je rak koji raste na usni jednog trkačkog konja koji se zove Ginis. To je veoma, veoma smrtonosna vrsta raka po imenu angiosarkom. Već se proširio na njegove limfne čvorove, tako da smo koristili kremu za usnu, kao i koktel, kako bismo ga lečili iznutra i spolja. I u roku od šest meseci potpuno se oporavio. A evo ga šest godina posle, Ginis, sa svojim srećnim vlasnikom.
(Applause)
(aplauz)
Now obviously, antiangiogenic therapy could be used for a wide range of cancers. And in fact, the first pioneering treatments for people as well as dogs, are already becoming available. There are 12 different drugs, 11 different cancer types. But the real question is: How well do these work in practice? So here's actually the patient survival data from eight different types of cancer. The bars represent survival time taken from the era in which there was only chemotherapy, or surgery, or radiation available. But starting in 2004, when antiangiogenic therapies first became available, you can see that there has been a 70 to 100 percent improvement in survival for people with kidney cancer, multiple myeloma, colorectal cancer, and gastrointestinal stromal tumors. That's impressive. But for other tumors and cancer types, the improvements have only been modest.
Očigledno da se antiangiogenetska terapija može koristiti za razne vrste tumora. Ustvari, prva pionirska lečenja, namenjena ljudima kao i životinjama, već postaju dostupna. Postoji 12 različitih lekova, 11 različitih vrsta raka, ali pravo pitanje je: koliko su oni dobri u praksi? Evo podataka o izlečenim pacijentima od osam različitih vrsta raka. Ovi podaci predstavljaju vreme preživljavanja koje je uzeto iz ere kada su bile dostupne samo hemoterapija ili operacija ili radijacija. Ali počevši od 2004. kada su prve antioangiogenetske terapije postale dostupne, možete videti da je za 70 do 100 procenata povećano preživljavanje za ljude sa rakom bubrega, višestrukim mijelomima, kolorektalnim rakom i gastrointestinalnim stromalnim tumorom. To je impresivno. Ali za druge tumore i vrste raka poboljšanja su skromna.
So I started asking myself, "Why haven't we been able to do better?" And the answer, to me, is obvious: we're treating cancer too late in the game, when it's already established, and oftentimes, it's already spread or metastasized. And as a doctor, I know that once a disease progresses to an advanced stage, achieving a cure can be difficult, if not impossible. So I went back to the biology of angiogenesis, and started thinking: Could the answer to cancer be preventing angiogenesis, beating cancer at its own game, so the cancers could never become dangerous? This could help healthy people, as well as people who've already beaten cancer once or twice, and want to find a way to keep it from coming back.
Tako sam se zapitao, "Zašto nismo uspeli da postignemo više?" A odgovor je, po meni, očigledan; lečimo rak prekasno, kada se već smesti i često, već se i raširio i metastazirao. I kao doktor, ja znam da, kada bolest uznapreduje, postizanje izlečenja može biti teško, ako ne i nemoguće. Onda sam se vratio na biologiju angiogeneze i počeo da razmišljam: da li bi lek za rak mogla da bude prevencija angiogeneze, pobeda raka u njegovoj igri tako da rak nikada ne postane opasan? Ovo bi moglo da pomogne zdravim ljudima kao i onima koji su već pobedili rak jednom ili dva puta i žele da nađu način da se on ne vrati.
So to look for a way to prevent angiogenesis in cancer, I went back to look at cancer's causes. And what really intrigued me, was when I saw that diet accounts for 30 to 35 percent of environmentally-caused cancers. Now the obvious thing is to think about what we could remove from our diet, what to strip out, take away. But I actually took a completely opposite approach, and began asking: What could we be adding to our diet that's naturally antiangiogenic, and that could boost the body's defense system, and beat back those blood vessels that are feeding cancers? In other words, can we eat to starve cancer?
Dakle, da bih pronašao način da sprečim angiogenezu kod raka, vratio sam se na uzroke raka. I ono što me je stvarno kopkalo, je kad sam video da ishrana učestvuje sa 30 do 35% u rakovima koji uzrok imaju u okruženju. Sad, očigledno bi bilo da razmišljamo o tome šta bismo mogli da izbacimo iz ishrane, da smanjimo. Ali ja sam imao potpuno suprotan pristup i počeo da pitam: šta bismo mogli da dodamo našoj ishrani što je prirodno antiangiogenetsko, što bi moglo da ojača odbrambeni sistem tela i pobedi te krvne sudove koji hrane rak? Drugim rečima, možemo li da jedemo da bismo izgladneli rak?
(Laughter)
Pa, odgovor je da.
Well, the answer is yes, and I'm going to show you how. And our search for this has taken us to the market, the farm and to the spice cabinet, because what we've discovered is that Mother Nature has laced a large number of foods and beverages and herbs with naturally-occurring inhibitors of angiogenesis.
I pokazaću vam kako. Naše istraživanje ovoga odvelo nas je na pijacu, na farmu i među začine, jer otkrili smo da nam je majka priroda podarila veliki broj hrane i pića i bilja koja sadrže prirodne inhibitore angiogeneze.
Here's a test system we developed. At the center is a ring from which hundreds of blood vessels are growing out in a starburst fashion. And we can use this system to test dietary factors at concentrations that are obtainable by eating. Let me show you what happens when we put in an extract from red grapes. The active ingredient is resveratrol, it's also found in red wine. This inhibits abnormal angiogenesis, by 60 percent. Here's what happens when we added an extract from strawberries. It potently inhibits angiogenesis. And extract from soybeans. And here is a growing list of antiangiogenic foods and beverages that we're interested in studying. For each food type, we believe that there are different potencies within different strains and varietals. And we want to measure this because, well, while you're eating a strawberry or drinking tea, why not select the one that's most potent for preventing cancer?
Evo sistema za test koji smo razvili. U centru je krug iz kog stotine krvnih sudova polaze u obliku zvezde. Možemo koristiti ovaj sistem za testiranje hranljivih faktora u koncentracijama koje se dobijaju putem jela. Pokazaću vam šta se dešava kada stavimo ekstrakt crnog grožđa. Aktivni sastojak je resveratrol. Može se naći i u crnom vinu. Ovo inhibira abnormalnu angiogenezu za 60 procenata. Evo šta se dešava kada dodamo ekstrakt jagoda. To veoma moćno inhibira angiogenezu. I ekstrakt soje. A evo i naše rastuće liste antiangiogenetskih pića i hrane koje želimo da proučimo. I mislimo da za svaku vrstu hrane postoje različite snage u okviru različitih vrsta i varijacija. I ovo želimo da merimo jer, pa, kad jedete jagode ili pijete čaj, zašto ne biste izabrali onaj koji je najjači u prevenciji raka.
So here are four different teas that we've tested. They're all common ones: Chinese jasmine, Japanese sencha, Earl Grey and a special blend that we prepared, and you can see clearly that the teas vary in their potency, from less potent to more potent. But what's very cool is when we combine the two less potent teas together, the combination, the blend, is more potent than either one alone. This means there's food synergy.
Evo četiri različita čaja koja smo testirali. Oni su svi uobičajeni, kineski jasmin, vrsta japanskog zelenog čaja, Earl Grey i posebna mešavina koju smo mi pripremili. I jasno možete videti da čajevi varijaju u snazi od manje snažnog do snažnijeg. Ali ono što je super je kad smo pomešali dva manje snažna čaja, ta kombinacija, mešavina, snažnija je od oba čaja posebno. To znači da postoji sinergija hrane.
Here's some more data from our testing. Now in the lab, we can simulate tumor angiogenesis, represented here in a black bar. And using this system, we can test the potency of cancer drugs. So the shorter the bar, the less angiogenesis -- that's good. And here are some common drugs that have been associated with reducing the risk of cancer in people. Statins, nonsteroidal anti-inflammatory drugs, and a few others -- they inhibit angiogenesis, too. And here are the dietary factors going head-to-head against these drugs. You can see they clearly hold their own, and in some cases, they're more potent than the actual drugs. Soy, parsley, garlic, grapes, berries. I could go home and cook a tasty meal using these ingredients. Imagine if we could create the world's first rating system, in which we could score foods according to their antiangiogenic, cancer-preventative properties. And that's what we're doing right now.
Evo još nekih podataka iz naših testiranja. E sad, u laboratoriji simuliramo angiogenezu tumora, što je prikazano crnim stupcem. Koristeći ovaj sistem možemo da testiramo snagu lekova protiv raka. Dakle, kraći stubac, manje angiogeneze, to je dobro. A evo i nekih uobičajenih lekova za koje se smatra da smanjuju rizik od raka kod ljudi. Statini, antizapaljenski lekovi bez steroida, i još neki, oni takođe inhibiraju angiogenezu. A evo i faktora ishrane koji idu rame uz rame sa ovim lekovima. Možete videti da oni očigledno imaju svoje, a u nekim slučajevima su i jači od običnih lekova. Soja, peršun, beli luk, grožđe, bobice, mogao bih da odem kući i skuvam ukusan obrok sa ovim sastojcima. Zamislite da možemo da napravimo prvi sistem da ocenjivanje hrane gde bismo mogli da bodujemo hranu prema tome kolika su im antiangiogenetska i svojstva koja preveniraju rak. I to ćemo upravo sada da uradimo.
Now, I've shown you a bunch of lab data, and so the real question is: What is the evidence in people that eating certain foods can reduce angiogenesis in cancer? Well, the best example I know is a study of 79,000 men followed over 20 years, in which it was found that men who consumed cooked tomatoes two to three times a week, had up to a 50 percent reduction in their risk of developing prostate cancer. Now, we know that tomatoes are a good source of lycopene, and lycopene is antiangiogenic. But what's even more interesting from this study, is that in those men who did develop prostate cancer, those who ate more servings of tomato sauce, actually had fewer blood vessels feeding their cancer. So this human study is a prime example of how antiangiogenic substances present in food and consumed at practical levels, can have an impact on cancer. And we're now studying the role of a healthy diet -- with Dean Ornish at UCSF and Tufts University -- the role of this healthy diet on markers of angiogenesis that we can find in the bloodstream.
Sad, pokazao sam vam gomilu podataka iz laboratorije, a pravo pitanje je: kakvi su dokazi na ljudima, da konzumiranje određene hrane može smanjiti angiogenezu kod raka? Pa, najbolji primer koji znam je studija o 79.000 muškaraca koji su praćeni preko 20 godina, u kojoj je utvrđeno da je muškarcima koji su konzumirali kuvani paradajz dva do tri puta nedeljno, rizik od razvijanja raka prostate bio smanjen za 50%. Sad, znamo da je paradajz dobar izvor likopena, a likopen je antiangiogenetski. Ali ono što je iz ove studije još interesantnije je da oni muškarci kod kojih se ipak razvio rak prostate, oni koji su jeli više porcija paradajz sosa, oni su imali manje krvnih sudova koji su hranili rak. Dakle ova ljudska studija je glavni primer toga kakav uticaj antiangiogenetske supstance, koje su prisutne u hrani i konzumiraju se u praktičnim količinama, mogu imati na rak. A sada proučavamo ulogu zdrave ishrane sa Dinom Ornišem i kalifornijskim i Tufts univerzitetom, ulogu ove zdrave ishrane na markere angiogeneze koje možemo da pronađemo u krvotoku.
Obviously, what I've shared with you has some far-ranging implications, even beyond cancer research. Because if we're right, it could impact consumer education, food services, public health and even the insurance industry. And in fact, some insurance companies are already beginning to think along these lines. Check out this ad from BlueCross BlueShield of Minnesota. For many people around the world, dietary cancer prevention may be the only practical solution, because not everybody can afford expensive end-stage cancer treatments, but everybody could benefit from a healthy diet based on local, sustainable, antiangiogenic crops.
Sad, očigledno da ovo što sam podelio s vama ima neke široke implikacije, čak i dalje od proučavanja raka. Jer ako smo u pravu, to bi moglo uticati na obrazovanje potrošača, restorane, javno zdravlje, čak i na industriju osiguranja. Zapravo, neke osiguravajuće kompanije već počinju da razmišljaju u skladu sa ovim. Pogledajte ovaj oglas iz Blue Cross Blue Shield iz Minesote. I za mnoge ljude širom sveta prevencija raka ishranom može biti jedino praktično rešenje jer ne mogu svi da priušte skupa lečenja ali svi mogu imati koristi od zdrave ishrane koja se zasniva na lokalnim, održivim antiangiogenetskim usevima.
Now, finally, I've talked to you about food, and I've talked to you about cancer, so there's just one more disease that I have to tell you about, and that's obesity. Because it turns out that adipose tissue -- fat -- is highly angiogenesis-dependent. And like a tumor, fat grows when blood vessels grow. So the question is: Can we shrink fat by cutting off its blood supply? The top curve shows the body weight of a genetically obese mouse that eats nonstop until it turns fat, like this furry tennis ball.
Sada, konačno, pričam o hrani, pričam vam i o raku, ali ima još samo jedna bolest o kojoj moram da vam ispričam, a to je gojaznost. Ispostavlja se da masno tkivo, salo, veoma zavisi od angiogeneze. I kao i tumor, salo se širi kad se krvni sudovi množe. Znači pitanje je: možemo li da smanjimo salo tako što ćemo mu prekinuti dotok krvi? Gornja krivulja pokazuje telesnu masu genetski gojaznog miša koji neprekidno jede, dok se ne pretvori u ovakvu krznenu tenisku lopticu.
(Laughter)
A donja krivulja je težina normalnog miša.
And the bottom curve is the weight of a normal mouse.
Ako uzmete gojaznog miša i date mu
If you take the obese mouse and give it an angiogenesis inhibitor, it loses weight. Stop the treatment, gains the weight back. Restart the treatment, loses the weight. Stop the treatment, it gains the weight back. And, in fact, you can cycle the weight up and down simply by inhibiting angiogenesis. So this approach that we're taking for cancer prevention may also have an application for obesity. The truly interesting thing about this is that we can't take these obese mice and make them lose more weight than what the normal mouse's weight is supposed to be. In other words, we can't create supermodel mice.
inhibitor antiangiogeneze, on izgubi na težini. Prekinete tretman, opet se ugoji. Ponovo počnete tretman, opet izgubi na težini. Prekinete tretman, opet se ugoji. I ustvari, možete da menjate težinu gore dole samo inhibiranjem angiogeneze. Znači ovaj pristup koji imamo za prevenciju raka možda može da se primeni i na gojaznost. Stvarno veoma interesantna stvar u vezi s ovim je da ne možemo gojaznom mišu smanjiti težinu više nego što bi trebala da bude težina normalnog miša. Drugim rečima, ne možemo napraviti miševe super modele.
(Laughter)
(smeh)
And this speaks to the role of angiogenesis in regulating healthy set points.
I to govori o ulozi angiogeneze u regulaciji zdravih vrednosti.
Albert Szent-Györgi once said, "Discovery consists of seeing what everyone has seen, and thinking what no one has thought."
Albert Snet-Đerđ je jednom rekao da se "Otkriće sastoji u tome da vidimo ono što svi vide, i da mislimo da ono što niko nije mislio."
I hope I've convinced you that for diseases like cancer, obesity and other conditions, there may be a great power in attacking their common denominator: angiogenesis. And that's what I think the world needs now.
Nadam se da sam vas ubedio da, kod bolesti kao što su rak, gojaznost i neke druge, može biti veoma moćno da se napadne njihov zajednički imenitelj, angiogeneza. I to je ono što ja mislim da je svetu potrebno sada. Hvala.
Thank you.
(aplauz)
(Applause)
June Cohen: I have a quick question for you.
Džun Koen: Dakle ovi lekovi nisu -
JC: So these drugs aren't exactly in mainstream cancer treatments right now. For anyone out here who has cancer, what would you recommend? Do you recommend pursuing these treatments now, for most cancer patients?
oni nisu deo rasprostranjenog lečenja raka u ovom trenutku. Za nekoga ko ima rak, šta biste preporučili? Da li preporučujete, većini obolelih od raka, da traže ove tretmane?
William Li: There are antiangiogenic treatments that are FDA approved, and if you're a cancer patient, or working for one or advocating for one, you should ask about them. And there are many clinical trials. The Angiogenesis Foundation is following almost 300 companies, and there are about 100 more drugs in that pipeline. So, consider the approved ones, look for clinical trials, but then between what the doctor can do for you, we need to start asking what can we do for ourselves. This is one of the themes I'm talking about: We can empower ourselves to do the things that doctors can't do for us, which is to use knowledge and take action. And if Mother Nature has given us some clues, we think there might be a new future in the value of how we eat, and what we eat is really our chemotherapy three times a day.
Vilijam Li: Postoje antiangiogenetski lekovi koje je odobrila administracija za lekove. I ako ste oboleli od raka, ili radite za nekog ili zastupate nekog ko jetse, trebalo bi da ih tražite. Postoji i mnogo kliničkih proba. Fondacija Angiogeneze prati skoro 3000 kompanija, a postoji još oko 100 lekova u najavi. Dakle razmislite o postojećim, tražite kliničke probe, ali između onoga što lekari mogu da učine za vas, moramo početi da se pitamo šta možemo da učinimo za sebe. Ovo je jedna od tema o kojima pričam, možemo se osnažiti da uradimo one stvari koje lekari ne mogu da urade za nas, a to je da iskoristimo znanje i krenemo u akciju. I ako nam je majka priroda dala neke znake, mislimo da se nova budućnost možda nalazi u vrednosti onoga što jedemo. A ono što jedemo jeste naša hemoterapija tri puta dnevno.
JC: Right. And along those lines, for people who might have risk factors for cancer, would you recommend pursuing any treatments prophylactically, or simply pursuing the right diet, with lots of tomato sauce?
DžK: Dobro. Detaljije, da li biste ljudima koji imaju faktor rizika od raka preporučili neke preventivne tretmane ili samo da istraju u zdravoj ishrani sa mnogo paradajz sosa?
WL: Well, you know, there's abundant epidemiological evidence, and I think in the information age, it doesn't take long to go to a credible source like PubMed, the National Library of Medicine, to look for epidemiological studies for cancer risk reduction based on diet and based on common medications. And that's certainly something that anybody can look into.
VL: Pa, znate, postoje bogati epidemiološki dokazi. I mislim da, u informatičkom vremenu, nije potrebno mnogo da se ode do pouzdanog izvora, kao što su Pubmed, Nacionalna medicinska biblioteka, i da se potraže epidemiološke studije o smanjenju rizika od raka na osnovu ishrane i na osnovu uobičajenih lekova. A to je svakako nešto što svako može da vidi.
JC: Okay. Well, thank you so much.
DžK: Okej. Pa, hvala Vam mnogo.
(Applause)
(aplauz)